Sears S F, Todaro J F, Urizar G, Lewis T S, Sirois B, Wallace R, Sotile W, Curtis A B, Conti J B
University of Florida, Department of Clinical & Health Psychology, Gainesville, USA.
Pacing Clin Electrophysiol. 2000 Jun;23(6):939-45. doi: 10.1111/j.1540-8159.2000.tb00878.x.
The implantable cardioverter defibrillator (ICD) provides a survival advantage over antiarrhythmic medications for patients with life-threatening ventricular arrhythmias. However, the effect of ICD therapy on quality-of-life and psychosocial functioning are not as well understood. Health care providers (e.g., physicians, nurses) can serve as a valuable source of information related to these ICD outcomes. The purpose of this study was to investigate health care provider perceptions regarding: (1) the quality-of-life and psychosocial functioning of their ICD recipients, (2) the concerns or problems reported by ICD recipients, and (3) the degree of provider comfort in managing these concerns. The final sample of health care providers (n = 261) rated ICD recipients' global quality-of-life and psychosocial functioning, and specific concerns about health care, lifestyle, special population adjustment, marital and family adjustment, and emotional well-being. With regard to quality-of-life, health care providers reported that the majority of ICD recipients were functioning better (38%) or about the same (47%) than before implantation. However, health care providers reported that 15% of recipients experienced worse quality-of-life postimplantation. Similarly, health care providers indicated that 10%-20% of ICD recipients experienced worse emotional functioning and strained family relationships. Moreover, issues related to driving, dealing with ICD shocks, and depression were the most common ICD recipient concerns. Significant differences were noted between physicians and nurses/other health care professionals on a wide range of psychosocial issues. Health care providers generally reported the most comfort dealing with traditional medical issues (i.e., patient adherence), and the least comfort in managing emotional well-being issues (e.g., depression and anxiety). These results suggest that routine attention to ICD quality-of-life and psychosocial outcomes is indicated for health care providers who care for ICD recipients.
对于患有危及生命的室性心律失常的患者，植入式心脏复律除颤器（ICD）比抗心律失常药物具有生存优势。然而，ICD治疗对生活质量和心理社会功能的影响尚未得到充分了解。医疗保健提供者（如医生、护士）可以作为与这些ICD结果相关的宝贵信息来源。本研究的目的是调查医疗保健提供者对以下方面的看法：（1）其ICD接受者的生活质量和心理社会功能；（2）ICD接受者报告的担忧或问题；（3）提供者在处理这些担忧时的舒适程度。最终样本中的医疗保健提供者（n = 261）对ICD接受者的总体生活质量和心理社会功能，以及对医疗保健、生活方式、特殊人群调整、婚姻和家庭调整以及情绪健康的具体担忧进行了评分。关于生活质量，医疗保健提供者报告说，大多数ICD接受者的功能比植入前更好（38%）或大致相同（47%）。然而，医疗保健提供者报告说，15%的接受者植入后生活质量变差。同样，医疗保健提供者指出，10%-20%的ICD接受者情绪功能变差，家庭关系紧张。此外，与驾驶、应对ICD电击和抑郁相关的问题是ICD接受者最常见的担忧。在广泛的心理社会问题上，医生与护士/其他医疗保健专业人员之间存在显著差异。医疗保健提供者通常报告说，处理传统医疗问题（即患者依从性）时最舒适，而处理情绪健康问题（如抑郁和焦虑）时最不舒适。这些结果表明，对于照顾ICD接受者的医疗保健提供者来说，应常规关注ICD的生活质量和心理社会结果。
